Talk:Anemia

Thanks

Thanks to whomever removed the badly written nonsense about sunburns and cancer just ahead of me. Parts of it were just nonsense, and the rest confused cause and effect (e.g., cancer and/or its treatment can cause anemia, but anemia does not cause neoplastic disease). 66.124.70.108 07:05, 18 December 2006 (UTC)

Ice Cube Habit

I am dead serious about this... I have found that many women with Anemia (Iron deficiency type) have a habit of sucking/chewing on ice cubes quite frequently. I am very curious where this comes from any why they have this urge. It is definitely prevolent among them however.

161.225.1.12 00:15, 1 September 2006 (UTC)

No one can really say what the mechanism is. See pagophagia for some discussion. - Nunh-huh 00:20, 1 September 2006 (UTC)

Yeah there should be a mention of this here "Pica is the consumption of non-food such as dirt, paper, wax, grass and hair. It is a rare but characteristic sign of iron deficiency anemia." Simply add in "ice" there. 70.101.113.53 21:53, 1 September 2007 (UTC)

Anaemia vs anemia

This article uses British and American spellings of 'an(a)emia' inconsistently. Vacuum 23:50, Oct 14, 2004 (UTC)

Please correct to US english accordingly (the title is US). JFW | T@lk 07:34, 15 Oct 2004 (UTC)

Or change all of them to the UK spelling... —Preceding unsigned comment added by 82.27.226.27 (talk) 20:47, 5 March 2008 (UTC)

Macrocytic and megaloblastic

It is a very serious error to equate macrocytic and megaloblastic anaemiae (Let me use commonwealth English here). The latter consists of blasts and not erythrocytes - megaloblasts are formed due to defects in the synthesis of essential macromolecules. Macrocytic essentially means an increase in size, and can be due to a variety of reasons. Balaji Ravichandran (talk · contribs)

{{sofixit}}. JFW | T@lk 15:23, 23 January 2006 (UTC)

Kinetic and morphologic

Joewright, what is your source for the terminology? JFW | T@lk 21:17, 23 January 2006 (UTC)

Up-to-Date article on "approach to the adult patient with anemia" and lectures I've seen--and sorry I did not cite the U-t-D article, as I know that "cite is the new black"! will cite. Looking back I see that I've extended its own version of this kinetic/morphologic split from classification and into clinical approach. I'm not sure this is totally legit in terms of verifiabilility--though I can observe the approaches in action seeing different approaches on the wards. I'll look for a more solid cite. Joewright 21:24, 23 January 2006 (UTC)

The American literature seems to favor the "kinetic" approach, while the UK literature appears to favour classification by MCV. In the Oxford Textbook of Medicine (22.23.5 General approach to the anaemic patient) reticulocytes are only mentioned in passing and certainly not as a defining feature. JFW | T@lk 21:27, 23 January 2006 (UTC)

Yes, I know. But, the Oxford Textbook of Medicine is quite out of date compared to the latest edition of Harrison's, Wintrobe's or Hoffman's. In fact, the last edition of Wintrobe's went on to classify anaemia purely on pathogenetic differences, rather than clinically. The concept of 'reticulocyte production index' is relatively new; and was recently found to be better for diagnostic purposes. I don't remember where I read this - probably Ann Intern Med or N Engl J Med. If I come across the source, I'll plug it in.Balaji 08:43, 25 January 2006 (UTC)

• I found an explanation of the RPI in Harrison's and made a page for reticulocyte production index so if you do find a ref, let's put it in the RPI page also. I wasn't able to find useful references that directly addressed it in a PubMed search. Also, I was curious about whether my impression was correct and asked a 3rd year student friend of mine what her impression was; she says that in her experience people start with MCV--perhaps as a practical matter since it comes back with the CBC--but that they get the retic count before they call for a hematology consult since the hematologists will criticize them if they don't have it. Ah, medicine. Anyway, I'm not sure that this is really an "approach" and anyway it's not citable, but in practical terms I think I'm resolved to continue backing away from my idea that there are really distinct clinical approaches that you can label. Joewright 16:17, 25 January 2006 (UTC)

I've seen the RPI mentioned on Emedicine. It must have a source. As far as I can say from my UK experience, reticulocyte counts are only useful in specific settings, e.g. ?haemolysis. From a classification perspective, it is appealing to think in terms of production/destruction just like bilirubin can be elevated due to high production, slow conjugation or slow excretion. Still, from a clinician's perspective a reticulocyte count will not narrow down the differential enough - e.g. Hb low & MCV low - is this iron deficiency or thalassaemia? JFW | T@lk 17:38, 25 January 2006 (UTC)

But wouldn't the retic count be high in thalassemia (sorry, thallassaemia!) and low in iron deficiency? This is the kind of argument people use for the retic count. If you think about this as a production vs destruction issue, then wouldn't the retic count immediately put your two examples into different categories? So if it is thal then the retics are high, then you are led to think of a destruction/loss cause; and since the MCV is low, destruction due to problems of the cells is more likely than simple loss. Obviously then narrowing it down among the potential problems with cells will require smear, examination of hemoglobin, etc. for the final diagnosis--but it leads you quickly to do that instead of a therapeutic trial of iron, and that speed in getting to the right answer would be the argument for getting retics early. This is not my area of expertise (not that I have one), but that's the logic that I use in liking the retic count. Am I wrong? Joewright 19:23, 25 January 2006 (UTC)

High retics in thalassaemia? JFW | T@lk 00:06, 26 January 2006 (UTC)

you're right--I'd been writing quickly and had briefly looked at [1] and believed it b/c I was thinking of hemolytic anemias generally but I found other refs that say it's usually normal (b/c despite increased production there is ineffective erythropoiesis and sequestration of retics in spleen)--Joewright 00:56, 26 January 2006 (UTC)

More risk factors

Should we perhaps mention some of the risk factors for an(a)emia beyond diet and pregnancy, particularly infectious diseases like malaria, hookworm, HIV etc.? Procrastinator supreme 08:49, 2 May 2006 (UTC)

The risk factors should be mentioned under the type of anemia. E.g. hookworm gives a microcytic picture, while in HIV the causes are multiple (e.g. AZT causing macrocytosis). JFW | T@lk 16:37, 2 May 2006 (UTC)

Heinz body anemia

Someone wants to create this as a separate article. My sense was that it was subsumed into specific hemolytic anemias (e.g. thalassemia and therefore should be merged into this one. Mangoe 03:39, 7 September 2006 (UTC)

P.S> if someone knowledgeable could review Heinz body I would appreciate it. Mangoe 03:41, 7 September 2006 (UTC)

Serum B12 and Schilling Test

This is an excellent bang-up article. Quite impressed. Learned a lot- this is after having read the Merck manual and all the online sources I could put my hands on. Notes for further inclusion in the article. Normal B12 blood serum is (165-740) pmol/L. And a cinical test for pernicious anemia is Schillings Test. that must be a kinetic test. Best Wishes. Will314159 02:45, 28 September 2006 (UTC)

Diet & Anemia

I'm curious about the candy bar reference. I didn't read the whole article, and the line cites a document that's not listed in the references or "see also" list. What exactly is in candy bars (besides maybe the chocolate) that's bad for iron absorbtion?128.152.20.33 22:41, 2 November 2006 (UTC)

Commentary moved from article

The term dimorphic is a misnomer and should be deleted, this section belongs under megaloblastic anemia.

-information obtained from Pathology course syllabus, UCCOM

Removed from section on dimorphic anemia. -Joelmills 04:11, 24 February 2007 (UTC)

Liver stores nine years of iron?

I removed the following phrase from the first sentence in the Diet & Anemia section:

"however, the average adult has approximately nine years worth of iron stored in the liver, and it would take four to five years of an iron-deficient diet to create iron-deficiency anemia from diet alone."

This phrase does not have any citation or attribution. I reviewed several encyclopedia entries on anemia and could find no information about this. Please cite a reference. Thanks. Rodrigotorres 22:01, 29 May 2007 (UTC)

statistics

Taken from the section on anemia during pregnancy: "Anemia affects 20% of all females of childbearing age in the United States." This statistic does not represent a worldwide view. A more global statistic should be found, or this should be removed. -007bond aka Matthew G aka codingmasters 11:23, 16 June 2007 (UTC)

Headings

Why are there two reference sections? 66.235.19.122 (talk) 03:29, 19 March 2008 (UTC)

I have changed one to a "Books" section. Snowman (talk) 10:25, 19 March 2008 (UTC)

High prevalence in Ancient Egypt

According to this; 74% among children and teens and 44% among adults. Esn (talk) 05:06, 1 April 2008 (UTC)

shunting of blood from splanchnic beds

i hear this happens in anemia and you get GI problems. Is this in the article anywhere? the article could say, "what kinds of problems arise from this shunting" - because that is my question. Thanks.